1
|
Patterson RH, Suleiman O, Hapunda R, Wilson B, Chadha S, Tucci D. Towards universal access: A review of global efforts in ear and hearing care. Hear Res 2024; 445:108973. [PMID: 38520900 DOI: 10.1016/j.heares.2024.108973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/12/2024] [Accepted: 02/10/2024] [Indexed: 03/25/2024]
Abstract
Hearing loss affects 1.6 billion people worldwide and disproportionately affects those in low- and middle-income countries. Despite being largely preventable or treatable, ear and hearing conditions result in significant and lifelong morbidity such as delayed language development, reduced educational attainment, and diminished social well-being. There is a need to augment prevention, early identification, treatment, and rehabilitation for these conditions. Expanded access to hearing screening, growth of the hearing health workforce, and innovations in ear and hearing care delivery systems are among the changes that are needed. To that end, the World Health Organization has prioritized ear and hearing care as a component of Universal Health Coverage, and recent publications have advanced the priority for ear and hearing care. Efforts are underway at the national levels around the world, as evidenced by countries like Zambia and Nigeria that have integrated ear and hearing care within national health strategies. While significant strides have been made in improving access, a critical need remains for additional research, advocacy, and intervention to ensure that no one is left behind in the goal to achieve universal access to ear and hearing care.
Collapse
Affiliation(s)
- Rolvix H Patterson
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, DUMC Box 3805 40 Duke Medicine Circle, Durham, NC 27710, United States; Hubert-Yeargan Center for Global Health, Duke University, 310 Trent Drive, Box 90518, Durham, NC 27710, United States.
| | - Olayinka Suleiman
- Department of Otorhinolaryngology Head and Neck Surgery, Federal Teaching Hospital, Katsina, Nigeria, 820101
| | - Racheal Hapunda
- Department of Surgery - Otolaryngology, University of Zambia, PO Box 32379, Lusaka, Zambia
| | - Blake Wilson
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, DUMC Box 3805 40 Duke Medicine Circle, Durham, NC 27710, United States; Departments of Biomedical Engineering and Electrical & Computer Engineering, Duke University Pratt School of Engineering Box 90291, Durham, NC 27708, United States
| | - Shelly Chadha
- Department on Noncommunicable Diseases, World Health Organization, Geneva, Av. Appia 20, 1202 Genève, Switzerland
| | - Debara Tucci
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, 31 Center Drive, MSC 2320, Bethesda, MD 20892-2320, United States
| |
Collapse
|
2
|
Dillard LK, Der CM, Laplante-Lévesque A, Swanepoel DW, Thorne PR, McPherson B, de Andrade V, Newall J, Ramos HD, Kaspar A, Nieman CL, Clark JL, Chadha S. Service delivery approaches related to hearing aids in low- and middle-income countries or resource-limited settings: A systematic scoping review. PLOS Glob Public Health 2024; 4:e0002823. [PMID: 38266001 PMCID: PMC10807760 DOI: 10.1371/journal.pgph.0002823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024]
Abstract
Hearing loss is an important global public health issue which can be alleviated through treatment with hearing aids. However, most people who would benefit from hearing aids do not receive them, in part due to challenges in accessing hearing aids and related services, which are most salient in low- and middle-income countries (LMIC) and other resource-limited settings. Innovative approaches for hearing aid service delivery can overcome many of the challenges related to access, including that of limited human resources trained to provide ear and hearing care. The purpose of this systematic scoping review is to synthesize evidence on service delivery approaches for hearing aid provision in LMIC and resource-limited settings. We searched 3 databases (PubMed, Scopus, Ovid MEDLINE) for peer-reviewed articles from 2000 to 2022 that focused on service delivery approaches related to hearing aids in LMIC or resource-limited settings. Fifteen peer-reviewed articles were included, which described hospital-based (3 studies), large-scale donation program (1 studies), community-based (7 studies), and remote (telehealth; 4 studies) service delivery approaches. Key findings are that hearing aid services can be successfully delivered in hospital- and community-based settings, and remotely, and that both qualified hearing care providers and trained non-specialists can provide quality hearing aid services. Service delivery approaches focused on community-based and remote care, and task sharing among qualified hearing care providers and trained non-specialists can likely improve access to hearing aids worldwide, thereby reducing the burden of untreated hearing loss.
Collapse
Affiliation(s)
- Lauren K. Dillard
- Department of Otolaryngology- Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Carolina M. Der
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Ariane Laplante-Lévesque
- Health Workforce and Service Delivery Unit, Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe, Copenhagen, Denmark
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology—Head & Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Peter R. Thorne
- Section of Audiology and Eisdell Moore Centre, University of Auckland, Auckland, New Zealand
| | - Bradley McPherson
- Centre for Hearing Research, School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Victor de Andrade
- Department of Speech Pathology and Audiology School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - John Newall
- Department of Linguistics, Macquarie University, Sydney, Australia
| | - Hubert D. Ramos
- Master in Clinical Audiology Program, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
| | | | - Carrie L. Nieman
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Jackie L. Clark
- University of Texas at Dallas–AuD Program, Dallas, Texas, United States of America
| | - Shelly Chadha
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
3
|
Chadha S, Dillard LK, Mariotti SP, Keel S. Monitoring hearing and vision functions in older adults: rationale and process. Age Ageing 2023; 52:iv158-iv161. [PMID: 37902514 PMCID: PMC10615057 DOI: 10.1093/ageing/afad123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Indexed: 10/31/2023]
Abstract
Hearing and vision impairment are highly prevalent in ageing individuals and are significant public health concerns given their meaningful impacts on individuals and society. Yet, many cases of both visual and hearing impairment remain unidentified and thus, unaddressed. This article describes the rationale and process of monitoring for visual and hearing impairment in older adults, by summarising guidance and resources available from the World Health Organisation (WHO) that were developed based upon the best current available evidence. It is recommended that vision screening be offered at least annually to adults aged over 50 years and hearing screening be offered every 5 years to adults aged 50-64 years, and every 1-3 years to adults aged 65 years or older. Both hearing and vision screening can be conducted in community, home or clinical settings by trained health workers with simple equipment. More specifically, vision screening can be conducted with a simple eye chart. Hearing screening can be conducted without specialised equipment by using pure tones set to a fixed level, an automated mobile- or web-based digits-in-noise test, or the whispered voice test. Hearing screening can also be conducted in audiology clinics using pure-tone air conduction threshold testing. There exists WHO guidance to support the monitoring of hearing and vision impairment, which, when warranted, can facilitate referral for comprehensive assessment and prompt appropriate, person-centred interventions to mitigate the negative consequences of hearing and vision impairment.
Collapse
Affiliation(s)
- Shelly Chadha
- Department on Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Lauren K Dillard
- Department of Otolaryngology—Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Silvio P Mariotti
- Department on Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Stuart Keel
- Department on Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
4
|
Canick J, Petrucci B, Patterson R, Saunders J, Htoo Thaw M, Omosule I, Denton A, Xu MJ, Chadha S, Young G, Siafa L, Mortel O, Shamshad A, Reddy A, McCalla M, Prasad K, Yang HH, Pan DR, Shah J, Smith E, Alkire B, Ibekwe T, Waterworth C. An analysis of the inclusion of ear and hearing care in national health policies, strategies and plans. Health Policy Plan 2023; 38:719-725. [PMID: 37130061 PMCID: PMC10274565 DOI: 10.1093/heapol/czad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 03/27/2023] [Accepted: 04/28/2023] [Indexed: 05/03/2023]
Abstract
Ear- and hearing-related conditions pose a significant global health burden, yet public health policy surrounding ear and hearing care (EHC) in low- and middle-income countries is poorly understood. The present study aims to characterize the inclusion of EHC in national health policy by analysing national health policies, strategies and plans in English, French, Spanish, Portuguese and Arabic. Three EHC keywords were searched, including ear*, hear* and deaf*. The terms 'human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)', 'tuberculosis' and 'malaria' were included as comparison keywords as these conditions have historically garnered political priority in global health. Of the 194 World Health Organization Member States, there were 100 national policies that met the inclusion criteria of document availability, searchable format, language and absence of an associated national EHC strategy. These documents mentioned EHC keywords significantly less than comparison terms, with mention of hearing in 15 documents, ears in 11 documents and deafness in 3 documents. There was a mention of HIV/AIDS in 92 documents, tuberculosis in 88 documents and malaria in 70 documents. Documents in low- and middle-income countries included significantly fewer mentions of EHC terms than those of high-income countries. We conclude that ear and hearing conditions pose a significant burden of disease but are severely underrepresented in national health policy, especially in low- and middle-income countries.
Collapse
Affiliation(s)
- Julia Canick
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | | | - Rolvix Patterson
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - James Saunders
- Division of Otolaryngology, Dartmouth Hitchcock Medical Center, Lebanon, NH 03766 , USA
| | | | - Ikeoluwa Omosule
- Department of Otorhinolaryngology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Alexa Denton
- Department of Otolaryngology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Mary Jue Xu
- Department of Otolaryngology—Head and Neck Surgery, UCSF, San Francisco , CA 94143, USA
| | - Shelly Chadha
- Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Gabrielle Young
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Lyna Siafa
- Faculty of Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | - Olivier Mortel
- Hôpital de l'Université d'état d'Haïti, Port-au-Prince, Haiti
| | - Alizeh Shamshad
- Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Ashwin Reddy
- Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Monet McCalla
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH 45701, USA
| | - Kavita Prasad
- Tufts University School of Medicine, Boston, MA 02111, USA
| | | | - Debbie R Pan
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Jaffer Shah
- Weill Cornell Medicine, New York, NY 10021, USA
| | - Emily Smith
- Duke Global Health Institute, Durham, NC 27710, USA
- Department of Surgery, Duke University, Durham, NC 27710, USA
| | - Blake Alkire
- Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA 02114, USA
| | - Titus Ibekwe
- Department of Otorhinolaryngology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Chris Waterworth
- Disability Inclusion for Health and Development, Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
- Audiology and Speech Pathology, University of Melbourne Faculty of Medicine, Dentistry, & Health Sciences, Carlton, VIC, Australia
| |
Collapse
|
5
|
Lin FR, Chadha S. Over-the-Counter Hearing Aids - Using Regulatory Policy to Improve Public Health. N Engl J Med 2023; 388:2117-2119. [PMID: 37272518 DOI: 10.1056/nejmp2302355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Frank R Lin
- From the Cochlear Center for Hearing and Public Health, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (F.R.L.); and the WHO Program for Prevention of Deafness and Hearing Loss, World Health Organization, Geneva (S.C.)
| | - Shelly Chadha
- From the Cochlear Center for Hearing and Public Health, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (F.R.L.); and the WHO Program for Prevention of Deafness and Hearing Loss, World Health Organization, Geneva (S.C.)
| |
Collapse
|
6
|
Oosthuizen I, Frisby C, Chadha S, Manchaiah V, Swanepoel DW. Combined hearing and vision screening programs: A scoping review. Front Public Health 2023; 11:1119851. [PMID: 36998276 PMCID: PMC10043331 DOI: 10.3389/fpubh.2023.1119851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023]
Abstract
Background and aim The World Health Organization (WHO) estimates that 1.5 billion and 2.2 billion people have hearing and vision impairment, respectively. The burden of these non-communicable diseases is highest in low- and middle-income countries due to a lack of services and health professionals. The WHO has recommended universal health coverage and integrated service delivery to improve ear and eye care services. This scoping review describes the evidence for combined hearing and vision screening programs. Method A keyword search of three electronic databases, namely Scopus, MEDLINE (PubMed), and Web of Science, was conducted, resulting in 219 results. After removing duplicates and screening based on eligibility criteria, data were extracted from 19 included studies. The Joanna Briggs Institute Reviewer Manual and the Preferred Reporting Items for Systematic Reviews and Meta-analyzes (PRISMA) Extension for Scoping Reviews were followed. A narrative synthesis was conducted. Results Most studies (63.2%) were from high-income countries, with 31.6% from middle-income and 5.2% from low-income countries. The majority of studies (78.9%) involved children and the four studies reporting on adults all included adults above 50 years of age. Vision screening was most commonly performed with the "Tumbling E" and "Snellen Chart," while hearing was typically screened using pure tone audiometry. Studies reported referral rates as the most common outcome with sensitivity and specificity rates not reported in any included articles. Reported benefits of combined vision and hearing screenings included earlier detection of vision and hearing difficulties to support functioning and quality of life as well as resource sharing for reduced costs. Challenges to combined screening included ineffective follow-up systems, management of test equipment, and monitoring of screening personnel. Conclusions There is limited research evidence for combined hearing and vision screening programs. Although potential benefits are demonstrated, especially for mHealth-supported programs in communities, more feasibility and implementation research are required, particularly in low- and middle-income countries and across all age groups. Developing universal, standardized reporting guidelines for combined sensory screening programs is recommended to enhance the standardization and effectiveness of combined sensory screening programs.
Collapse
Affiliation(s)
- Ilze Oosthuizen
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States
- University of Pretoria, Pretoria, South Africa
| | - Caitlin Frisby
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States
- University of Pretoria, Pretoria, South Africa
| | - Shelly Chadha
- WHO Programme for Prevention of Deafness and Hearing Loss, World Health Organization, Geneva, Switzerland
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States
- University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, United States
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, India
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States
- University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- Ear Science Institute Australia, Subiaco, WA, Australia
| |
Collapse
|
7
|
Dillard LK, Arunda MO, Lopez-Perez L, Martinez RX, Jiménez L, Chadha S. Prevalence and global estimates of unsafe listening practices in adolescents and young adults: a systematic review and meta-analysis. BMJ Glob Health 2022; 7:bmjgh-2022-010501. [PMID: 36379592 PMCID: PMC9723884 DOI: 10.1136/bmjgh-2022-010501] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study aimed to determine the prevalence of unsafe listening practices from exposure to personal listening devices (PLDs) and loud entertainment venues in individuals aged 12-34 years, and to estimate the number of young people who could be at risk of hearing loss from unsafe listening worldwide. METHODS We conducted a systematic review and meta-analysis to estimate the prevalence of unsafe listening practices from PLDs and loud entertainment venues. We searched three databases for peer-reviewed articles published between 2000 and 2021 that reported unsafe listening practices in individuals aged 12-34 years. Pooled prevalence estimates (95% CI) of exposed populations were calculated using random effects models or ascertained from the systematic review. The number of young people who could be at risk of hearing loss worldwide was estimated from the estimated global population aged 12-34 years, and best estimates of exposure to unsafe listening ascertained from this review. RESULTS Thirty-three studies (corresponding to data from 35 records and 19 046 individuals) were included; 17 and 18 records focused on PLD use and loud entertainment venues, respectively. The pooled prevalence estimate of exposure to unsafe listening from PLDs was 23.81% (95% CI 18.99% to 29.42%). There was limited certainty (p>0.50) in our pooled prevalence estimate for loud entertainment venues. Thus, we fitted a model as a function of intensity thresholds and exposure duration to identify the prevalence estimate as 48.20%. The global estimated number of young people who could be at risk of hearing loss from exposure to unsafe listening practices ranged from 0.67 to 1.35 billion. CONCLUSIONS Unsafe listening practices are highly prevalent worldwide and may place over 1 billion young people at risk of hearing loss. There is an urgent need to prioritise policy focused on safe listening. The World Health Organization provides comprehensive materials to aid in policy development and implementation.
Collapse
Affiliation(s)
- Lauren K Dillard
- Department of Otolaryngology Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | - Lucero Lopez-Perez
- Cluster of Healthier Populations, World Health Organization, Geneva, Switzerland
| | - Ricardo X Martinez
- Cluster of Healthier Populations, World Health Organization, Geneva, Switzerland
| | | | - Shelly Chadha
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
8
|
Edmond K, Chadha S, Hunnicutt C, Strobel N, Manchaiah V, Yoshinga-Itano C. Effectiveness of universal newborn hearing screening: A systematic review and meta-analysis. J Glob Health 2022; 12:12006. [PMID: 36259421 PMCID: PMC9579831 DOI: 10.7189/jogh.12.12006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Permanent bilateral hearing loss (PBHL) is a serious condition in newborns, with a prevalence of at least one per 1000 live births. However, there has been no recent systematic review and meta-analysis of the effectiveness of universal newborn hearing screening programs (UNHS). Methods We registered our study protocol on PROSPERO CRD42020175451. Primary outcomes were any identification of PBHL (ie, PBHL diagnosed at any time), age of identification of PBHL, and neurodevelopment. Two reviewers searched standard databases to March 2022 and extracted data. We used fixed and random effects meta-analysis to pool data and graded the certainty of evidence using standard methods. Results The search retrieved 2834 records. We identified five studies reporting on the effects of UNHS vs no UNHS in 1 023 610 newborns. The relative risk of being identified with PBHL before nine months in infants with UNHS compared to infants without UNHS was 3.28 (95% confidence interval (95% CI) = 1.84, 5.85, one study, 1 023 497 newborns, low certainty evidence). The mean difference in the age of identification of PBHL in infants with UNHS compared to infants without UNHS was 13.2 months earlier (95% CI = -26.3, -0.01, two studies, 197 newborns, very low certainty evidence). The relative risk of infants eventually being identified with PBHL in infants with UNHS compared to infants without UNHS was 1.01 (95% CI = 0.89, 1.14, three studies, 1 023 497 newborns, low certainty evidence). At the latest follow-up at 3-8 years, the standardised mean difference (SMD) in receptive language development between infants with UNHS compared to infants without UNHS was 0.60 z scores (95% CI = 0.07, 1.13, one study, 101 children, low certainty evidence) and the mean difference in developmental quotients was 7.72 (95% CI = -0.03, 15.47, three studies, 334 children, very low certainty evidence). The SMD in expressive language development was 0.39 z scores (95% CI = -0.20, 0.97, one study, 87 children, low certainty evidence) and the mean difference in developmental quotients was 10.10 scores (95% CI = 1.47, 18.73, 3 studies, 334 children, very low certainty evidence). Conclusions UNHS programs result in earlier identification of PBHL and may improve neurodevelopment. UNHS should be implemented across high-, middle-, and low-income countries. Registration PROSPERO (CRD42020175451).
Collapse
Affiliation(s)
| | | | | | | | - Vinaya Manchaiah
- University of Colorado Anschutz Medical Campus, Colorado, USA,University of Colorado Hospital, Colorado, USA,University of Pretoria, Gauteng, South Africa,Manipal Academy of Higher Education, Manipal, India
| | | | | |
Collapse
|
9
|
Tyagi V, Pahwa M, Chadha S, Mittal T, Ahuja A. Robot-assisted radical cystectomy with intracorporeal urinary diversion - An experience with hybrid sandwich technique. European Urology Open Science 2022. [DOI: 10.1016/s2666-1683(22)02186-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
10
|
Bhargava V, Jain A, Gupta P, Gupta A, Tiwari V, Bhalla A, Gupta A, Malik M, Chadha S, Rana D. POS-059 RENAL CRYPTOCOCCUS NEOFORMANS: AN UNUSUAL CASE OF ALLOGRAFT DYSFUNCTION. Kidney International Reports 2022. [DOI: 10.1016/j.ekir.2022.07.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
11
|
Dillard LK, Lopez-Perez L, Martinez RX, Fullerton AM, Chadha S, McMahon CM. Global burden of ototoxic hearing loss associated with platinum-based cancer treatment: A systematic review and meta-analysis. Cancer Epidemiol 2022; 79:102203. [PMID: 35724557 PMCID: PMC9339659 DOI: 10.1016/j.canep.2022.102203] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/10/2022] [Accepted: 06/12/2022] [Indexed: 11/06/2022]
Abstract
Platinum-based chemotherapeutic agents cisplatin and carboplatin are widely used in cancer treatment worldwide and may result in ototoxic hearing loss. The high incidence of cancer and salient ototoxic effects of platinum-based compounds pose a global public health threat. The purpose of this study was twofold. First, to estimate the prevalence of ototoxic hearing loss associated with treatment with cisplatin and/or carboplatin via a systematic review and meta-analysis. Second, to estimate the annual global burden of ototoxic hearing loss associated with exposure to cisplatin and/or carboplatin. For the systematic review, three databases were searched (Ovid Medline, Ovid Embase, and Web of Science Core Collection) and studies that reported prevalence of objectively measured ototoxic hearing loss in cancer patients were included. A random effects meta-analysis determined pooled prevalence (95% confidence intervals [CI]) of ototoxic hearing loss overall, and estimates were stratified by treatment and patient attributes. Estimates of ototoxic hearing loss burden were created with published global estimates of incident cancers often treated with platinum-based compounds and cancer-specific treatment rates. Eighty-seven records (n = 5077 individuals) were included in the meta-analysis. Pooled prevalence of ototoxic hearing loss associated with cisplatin and/or carboplatin exposure was 43.17% [CI 37.93–48.56%]. Prevalence estimates were higher for regimens involving cisplatin (cisplatin only: 49.21% [CI 42.62–55.82%]; cisplatin & carboplatin: 56.05% [CI 45.12–66.43%]) versus carboplatin only (13.47% [CI 8.68–20.32%]). Our crude estimates of burden indicated approximately one million individuals worldwide are likely exposed to cisplatin and/or carboplatin, which would result in almost half a million cases of hearing loss per year, globally. There is an urgent need to reduce impacts of ototoxicity in cancer patients. This can be partially achieved by implementing existing strategies focused on primary, secondary, and tertiary hearing loss prevention. Primary ototoxicity prevention via otoprotectants should be a research and policy priority. An estimated one million people are exposed to chemotherapeutic drugs per year. An estimated half a million cases of hearing loss per year are from chemotherapy. Hearing loss prevalence after exposure to cisplatin and/or carboplatin is 43%. Primary, secondary and tertiary prevention of hearing loss should be prioritized. Ototoxic hearing loss prevention is a global public health priority.
Collapse
Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States.
| | - Lucero Lopez-Perez
- Cluster of Healthier Populations, World Health Organization, Geneva, Switzerland
| | - Ricardo X Martinez
- Cluster of Healthier Populations, World Health Organization, Geneva, Switzerland
| | - Amanda M Fullerton
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
| | - Shelly Chadha
- Department on Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Catherine M McMahon
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
12
|
Neumann K, Mathmann P, Chadha S, Euler HA, White KR. Newborn Hearing Screening Benefits Children, but Global Disparities Persist. J Clin Med 2022; 11:271. [PMID: 35012010 PMCID: PMC8746089 DOI: 10.3390/jcm11010271] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 12/23/2022]
Abstract
There is substantial evidence that newborn hearing screening (NHS) reduces the negative sequelae of permanent childhood hearing loss (PCHL) if performed in programs that aim to screen all newborns in a region or nation (often referred to as Universal Newborn Hearing Screening or UNHS). The World Health Organization (WHO) has called in two resolutions for the implementation of such programs and for the collection of large-scale data. To assess the global status of NHS programs we surveyed individuals potentially involved with newborn and infant hearing screening (NIHS) in 196 countries/territories (in the following text referred to as countries). Replies were returned from 158 countries. The results indicated that 38% of the world's newborns and infants had no or minimal hearing screening and 33% screened at least 85% of the babies (hereafter referred to as UNHS). Hearing screening programs varied considerably in quality, data acquisition, and accessibility of services for children with PCHL. In this article, we summarize the main results of the survey in the context of several recent WHO publications, particularly the World Report on Hearing, which defined advances in the implementation of NHS programs in the Member States as one of three key indicators of worldwide progress in ear and hearing care (EHC).
Collapse
Affiliation(s)
- Katrin Neumann
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, 48149 Münster, Germany; (P.M.); (H.A.E.)
| | - Philipp Mathmann
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, 48149 Münster, Germany; (P.M.); (H.A.E.)
| | - Shelly Chadha
- Blindness Deafness Prevention, Disability and Rehabilitation Unit, Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, 1211 Geneva, Switzerland;
| | - Harald A. Euler
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, 48149 Münster, Germany; (P.M.); (H.A.E.)
| | - Karl R. White
- National Center for Hearing Assessment and Management, Utah State University, Logan, UT 84322, USA;
| |
Collapse
|
13
|
Tordrup D, Smith R, Kamenov K, Bertram MY, Green N, Chadha S. Global return on investment and cost-effectiveness of WHO's HEAR interventions for hearing loss: a modelling study. The Lancet Global Health 2022; 10:e52-e62. [PMID: 34919856 PMCID: PMC8692586 DOI: 10.1016/s2214-109x(21)00447-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 09/07/2021] [Accepted: 09/21/2021] [Indexed: 12/20/2022]
Abstract
Background To address the growing prevalence of hearing loss, WHO has identified a compendium of key evidence-based ear and hearing care interventions to be included within countries’ universal health coverage packages. To assess the cost-effectiveness of these interventions and their budgetary effect for countries, we aimed to analyse the investment required to scale up services from baseline to recommended levels, and the return to society for every US$1 invested in the compendium. Methods We did a modelling study using the proposed set of WHO interventions (summarised under the acronym HEAR: hearing screening and intervention for newborn babies and infants, pre-school and school-age children, older adults, and adults at higher risk of hearing loss; ear disease prevention and management; access to technologies such as hearing aids, cochlear implants, or hearing assistive technologies; and rehabilitation service provision), which span the life course and include screening and management of hearing loss and related ear diseases, costs and benefits for the national population cohorts of 172 countries. The return on investment was analysed for the period between 2020 and 2030 using three scenarios: a business-as-usual scenario, a progress scenario with a scale-up to 50% of recommended coverage, and an ambitious scenario with scale-up to 90% of recommended coverage. Using data for hearing loss burden from the Global Burden of Disease Study 2019, a transition model with three states (general population, diagnosed, and those who have died) was developed to model the national populations in countries. For the return-on-investment analysis, the monetary value of disability-adjusted life-years (DALYs) averted in addition to productivity gains were compared against the investment required in each scenario. Findings Scaling up ear and hearing care interventions to 90% requires an overall global investment of US$238·8 billion over 10 years. Over a 10-year period, this investment promises substantial health gains with more than 130 million DALYs averted. These gains translate to a monetary value of more than US$1·3 trillion. In addition, investment in hearing care will result in productivity benefits of more than US$2 trillion at the global level by 2030. Together, these benefits correspond to a return of nearly US$15 for every US$1 invested. Interpretation This is the first-ever global investment case for integrating ear and hearing care interventions in countries’ universal health coverage services. The findings show the economic benefits of investing in this compendium and provide the basis for facilitating the increase of country's health budget for strengthening ear and hearing care services. Funding None.
Collapse
Affiliation(s)
- David Tordrup
- WHO Collaborating Centre for Pharmaceutical Policy and Regulation, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, Netherlands; Triangulate Health, Doncaster, UK.
| | - Robert Smith
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Kaloyan Kamenov
- WHO Sensory Functions, Disability, and Rehabilitation Unit, World Health Organization, Geneva, Switzerland
| | - Melanie Y Bertram
- Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland
| | - Nathan Green
- Department of Statistical Science, University College London, London, UK
| | - Shelly Chadha
- WHO Sensory Functions, Disability, and Rehabilitation Unit, World Health Organization, Geneva, Switzerland
| |
Collapse
|
14
|
O'Donovan J, Nakku D, Nyanzi D, Nakasagga E, Hamala R, Namanda AS, Kabali K, Winters N, Chadha S, Bhutta MF. Training, supervision and performance of Community Health Workers in the delivery of ear and hearing care to 321 community members in rural Uganda. Clin Otolaryngol 2021; 46:1193-1199. [PMID: 34032012 DOI: 10.1111/coa.13815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/08/2021] [Accepted: 05/09/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Community Health Workers are one way to address the shortage of ear and hearing care specialists in low-resource settings. However, there are few reports evaluating training and service delivery by Community Health Workers. DESIGN, SETTING AND PARTICIPANTS We trained 13 Community Health Workers in primary ear and hearing care in Mukono District, Uganda. Community Health Workers attended a two-day training workshop and received remote supervision thereafter during service delivery in the community. An ear camp was held at the local health centre every two months, where a local ENT specialist could assess referred cases. MAIN OUTCOME MEASURES Clinical and diagnostic skills and decision-making were assessed using an Objective Structured Clinical Examination, with scores recorded at baseline and six months. Service delivery was evaluated by analysing the following: (i) number of individuals evaluated; (ii) treatments delivered; (iii) cases referred for specialist opinion; (iv) proportion of appropriately referred cases; and (v) agreement between Community Health Worker and specialist diagnosis. RESULTS Observed Structured Clinical Examination scores were high and stable for six months. 312 individuals were screened in the community by the Community Health Workers, with 298 classified as having an abnormality. Care was delivered in the community to 167 of these, and the remaining 131 referred to the ear camp. Diagnostic agreement was 39%, but 98% of referrals were deemed "appropriate" by the ENT specialist. 27 individuals self-presented to the ear camp without prior assessment by a Community Health Worker, and 97% of these were deemed appropriate. CONCLUSION Trained Community Health Workers can play an important role in delivering ear and hearing services. Future work should look to explore this model in other contexts and/or compare it to other models of service delivery.
Collapse
Affiliation(s)
- James O'Donovan
- Learning and New Technologies Research Group, Department of Education, University of Oxford, Oxford, UK.,Division of Research and Health Equity, Omni Med, Mukono, Uganda
| | - Doreen Nakku
- Department of Otolaryngology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Daniel Nyanzi
- Department of Otolaryngology, Kabale University, Kabale, Uganda
| | - Esther Nakasagga
- Department of Otolaryngology, Mbarara University of Science and Technology, Mbarara, Uganda.,Department of Ear, Nose and Throat Surgery, Kampala International University, Ishaka, Bushenyi, Uganda
| | - Rebecca Hamala
- Division of Research and Health Equity, Omni Med, Mukono, Uganda
| | - Allan S Namanda
- Division of Research and Health Equity, Omni Med, Mukono, Uganda
| | - Kenneth Kabali
- Division of Research and Health Equity, Omni Med, Mukono, Uganda
| | - Niall Winters
- Learning and New Technologies Research Group, Department of Education, University of Oxford, Oxford, UK
| | - Shelly Chadha
- WHO Programme for Prevention of Deafness and Hearing Loss, World Health Organization, Geneva, Switzerland
| | - Mahmood F Bhutta
- Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.,Brighton and Sussex Medical School, Brighton, UK
| |
Collapse
|
15
|
Dillard LK, Martinez RX, Perez LL, Fullerton AM, Chadha S, McMahon CM. Prevalence of aminoglycoside-induced hearing loss in drug-resistant tuberculosis patients: A systematic review. J Infect 2021; 83:27-36. [PMID: 34015383 DOI: 10.1016/j.jinf.2021.05.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
Objectives estimate the prevalence of ototoxic hearing loss in drug-resistant tuberculosis (DR-TB) patients treated with aminoglycoside antibiotics via a systematic review and meta-analysis. Estimate the annual preventable cases of hearing loss in DR-TB patients and leverage findings to discuss primary, secondary and tertiary prevention. Methods studies published between 2005 and 2018 that reported prevalence of post-treatment hearing loss in DR-TB patients were included. We performed a random effects meta-analysis to determine pooled prevalence of ototoxic hearing loss overall and by medication type. Preventable hearing loss cases were estimated using World Health Organization (WHO) data on DR-TB treatment and prevalence determined by the meta-analysis. Results eighteen studies from 10 countries were included. Pooled prevalence of ototoxic hearing loss and the corresponding 95% confidence interval (CI) was 40.62% CI [32.77- 66.61%] for all drugs (kanamycin: 49.65% CI [32.77- 66.61%], amikacin: 38.93% CI [26.44-53.07%], capreomycin: 10.21% CI [4.33-22.21%]). Non-use of aminoglycosides may result in prevention of approximately 50,000 hearing loss cases annually. Conclusions aminoglycoside use results in high prevalence of ototoxic hearing loss. Widespread prevention of hearing loss can be achieved by following updated WHO guidelines for DR-TB treatment. When hearing loss cannot be avoided, secondary and tertiary prevention should be prioritized.
Collapse
Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI 53726, United States.
| | - Ricardo X Martinez
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Lucero Lopez Perez
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Amanda M Fullerton
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
| | - Shelly Chadha
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Catherine M McMahon
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
16
|
Chadha S, Yan J, Chauhan N, Kumar A, Shukla P. Abstract No. 50 Hemorrhoid embolization: a meta-analysis of the Emborrhoid technique. Journal of Vascular and Interventional Radiology 2021. [DOI: 10.1016/j.jvir.2021.03.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
17
|
Kubiak A, Chauhan N, Chadha S, Yan J, Shukla P, Kumar A. Abstract No. 590 Contralateral lobe hypertrophy after selective Y90 radioembolization/Y90 segmentectomy. Journal of Vascular and Interventional Radiology 2021. [DOI: 10.1016/j.jvir.2021.03.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
18
|
Chadha S, Chauhan N, Hohenleitner J, Ranpura A, Kumar A, Shukla P. Abstract No. 451 Gallbladder ablation for cholecystitis: a systematic review for nonsurgical candidates. Journal of Vascular and Interventional Radiology 2021. [DOI: 10.1016/j.jvir.2021.03.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
19
|
Affiliation(s)
- Shelly Chadha
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Kaloyan Kamenov
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Alarcos Cieza
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| |
Collapse
|
20
|
Abstract
OBJECTIVE To estimate the global costs of hearing loss in 2019. DESIGN Prevalence-based costing model. STUDY SAMPLE Hearing loss data from the 2019 Global Burden of Disease study. Additional non-hearing related health care costs, educational support, exclusion from the labour force in countries with full employment and societal costs posed by lost quality of life were determined. All costs were reported in 2019 purchasing power parity (PPP) adjusted international dollars. RESULTS Total global economic costs of hearing loss exceeded $981 billion. 47% of costs were related to quality of life losses, with 32% due to additional costs of poor health in people with hearing loss. 57% of costs were outside of high-income countries. 6.5% of costs were for children aged 0-14. In scenario analysis a 5% reduction in prevalence of hearing loss would reduce global costs by $49 billion. CONCLUSION This analysis highlights major economic consequences of not taking action to address hearing loss worldwide. Small reductions in prevalence and/or severity of hearing loss could avert substantial economic costs to society. These cost estimates can also be used to help in modelling the cost effectiveness of interventions to prevent/tackle hearing loss and strengthen the case for investment.
Collapse
Affiliation(s)
- David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Shelly Chadha
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
21
|
Kamenov K, Chadha S. Methodological quality of clinical guidelines for universal newborn hearing screening. Dev Med Child Neurol 2021; 63:16-21. [PMID: 32981050 DOI: 10.1111/dmcn.14694] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 01/10/2023]
Abstract
AIM To review existing guidelines for universal newborn hearing screening (UNHS), identify those that provide comprehensive and clear recommendations on the subject, and provide a brief overview. METHOD A scoping literature review was performed in PubMed, the Guidelines International Network library, and national guideline databases to identify guidelines on newborn hearing screening developed or updated between 2004 and 2019. The quality of the guidelines was checked with the Checklist for the Quality Assessment of Guidelines (AGREE II). RESULTS Six guidelines met all the inclusion criteria. All six were based on the 1-3-6 benchmark (screening completed by 1mo, audiological diagnosis by 3mo, enrolment in early intervention by 6mo). However, the guidelines varied in terms of their recommendations for the application of screening methods, role of health professionals in the screening process, and quality. Based on the AGREE II score, flexibility, adaptability, and foundation role for all other guidelines, the 2019 guidelines of the Joint Committee on Infant Hearing position statement were identified as the most appropriate to be recommended for adaptation by countries or programmes. INTERPRETATION The diversity in the existing guidance can be confusing for countries and institutions that are planning to develop universal hearing screening programmes. As more countries and organizations develop their newborn hearing screening programmes, they will need examples to emulate. This review provides an evaluation of the quality, comprehensiveness, and applicability of existing clinical guidelines that can serve as a facilitator for countries, institutions, or organizations in their planning and implementation of a UNHS programme.
Collapse
Affiliation(s)
- Kaloyan Kamenov
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Shelly Chadha
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
22
|
Horgan P, Moore C, Baiden R, Basnyat B, Dutta S, Kapisi J, Pathak A, Phutke G, Smithuis F, Taneja N, Tinto H, Chadha S, Tomar A, Salami O, Olliaro P. Antimicrobial resistance diagnostic use accelerator – Behavioural determinants of point-of-care diagnostic uptake, and adherence to prescription. International Journal of Infectious Diseases 2020. [DOI: 10.1016/j.ijid.2020.09.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
23
|
Wang SK, Zhang H, Hu CY, Liu JF, Chadha S, Kim JW, Simmer JP, Hu JCC. FAM83H and Autosomal Dominant Hypocalcified Amelogenesis Imperfecta. J Dent Res 2020; 100:293-301. [PMID: 33034243 DOI: 10.1177/0022034520962731] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Autosomal dominant hypocalcified amelogenesis imperfecta (ADHCAI; OMIM #130900) is a genetic disorder exhibiting severe hardness defects and reduced fracture toughness of dental enamel. While the condition is nonsyndromic, it can be associated with other craniofacial anomalies, such as malocclusions and delayed or failed tooth eruption. Truncation mutations in FAM83H (OMIM *611927) are hitherto the sole cause of ADHCAI. With human genetic studies, Fam83h knockout and mutation-knock-in mouse models indicated that FAM83H does not serve a critical physiologic function during enamel formation and suggested a neomorphic mutation mechanism causing ADHCAI. The function of FAM83H remains obscure. FAM83H has been shown to interact with various isoforms of casein kinase 1 (CK1) and keratins and to mediate organization of keratin cytoskeletons and desmosomes. By considering FAM83H a scaffold protein to anchor CK1s, further molecular characterization of the protein could gain insight into its functions. In this study, we characterized 9 kindreds with ADHCAI and identified 3 novel FAM83H truncation mutations: p.His437*, p.Gln459*, and p.Glu610*. Some affected individuals exhibited hypoplastic phenotypes, in addition to the characteristic hypocalcification enamel defects, which have never been well documented. Failed eruption of canines or second molars in affected persons was observed in 4 of the families. The p.Glu610* mutation was located in a gap area (amino acids 470 to 625) within the zone of previously reported pathogenic variants (amino acids 287 to 694). In vitro pull-down studies with overexpressed FAM83H proteins in HEK293 cells demonstrated an interaction between FAM83H and SEC16A, a protein component of the COP II complex at endoplasmic reticulum exit sites. The interaction was mediated by the middle part (amino acids 287 to 657) of mouse FAM83H protein. Results of this study significantly extended the phenotypic and genotypic spectrums of FAM83H-associated ADHCAI and suggested a role for FAM83H in endoplasmic reticulum-to-Golgi vesicle trafficking and protein secretion (dbGaP phs001491.v1.p1).
Collapse
Affiliation(s)
- S K Wang
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.,Department of Dentistry, School of Dentistry, National Taiwan University, Jhongjheng District, Taipei City, Taiwan
| | - H Zhang
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - C Y Hu
- Department of Prosthodontics, National Taiwan University Hospital, Jhongjheng District, Taipei City, Taiwan
| | - J F Liu
- Division of Pediatric Dentistry, Department of Stomatology, Taichung Veterans General Hospital, Xitun District, Taichung City, Taiwan
| | - S Chadha
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J W Kim
- Department of Pediatric Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Department of Molecular Genetics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - J P Simmer
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J C C Hu
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
24
|
Best D, Chadha S, Wang C, Harriman E, Aronovich S. Surgical Outcomes of Maxillomandibular Advancement to Treat Obstructive Sleep Apnea in an Adolescent Population. Journal of Oral and Maxillofacial Surgery 2020. [DOI: 10.1016/j.joms.2020.07.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
25
|
Chadha S, Nirgudkar N, Shukla P, Cieslak J, Kumar A. 4:21 PM Abstract No. 81 Twitter use in medicine: comparison of interventional radiology, cardiology, and orthopedic surgery. Journal of Vascular and Interventional Radiology 2020. [DOI: 10.1016/j.jvir.2019.12.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
26
|
Cieslak J, Kubiak A, Chauhan N, Chadha S, Bertot J, Shukla P, Kumar A. 4:12 PM Abstract No. 30 Supereselective Y90 radioembolization: treating beyond threshold doses. Journal of Vascular and Interventional Radiology 2020. [DOI: 10.1016/j.jvir.2019.12.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
27
|
Shahid M, Nirgudkar N, Chadha S, Shukla P, Kumar A. Abstract No. 518 Safety and efficacy of percutaneous thermal ablation for primary and metastatic adrenal tumors: a systematic review. Journal of Vascular and Interventional Radiology 2020. [DOI: 10.1016/j.jvir.2019.12.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
28
|
Orji A, Kamenov K, Dirac M, Davis A, Chadha S, Vos T. Global and regional needs, unmet needs and access to hearing aids. International Journal of Audiology 2020; 59:166-172. [DOI: 10.1080/14992027.2020.1721577] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Aislyn Orji
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kaloyan Kamenov
- Department of noncommunicable diseases, World Health Organization, Geneva, Switzerland
| | - Mae Dirac
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Adrian Davis
- The Ear Institute, University College London, London, UK
| | - Shelly Chadha
- Department of noncommunicable diseases, World Health Organization, Geneva, Switzerland
| | - Theo Vos
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| |
Collapse
|
29
|
Harries AD, Schwoebel V, Monedero-Recuero I, Aung TK, Chadha S, Chiang CY, Conradie F, Dongo JP, Heldal E, Jensen P, Nyengele JPK, Koura KG, Kumar AMV, Lin Y, Mlilo N, Nakanwagi-Mukwaya A, Ncube RT, Nyinoburyo R, Oo NL, Patel LN, Piubello A, Rusen ID, Sanda T, Satyanarayana S, Syed I, Thu AS, Tonsing J, Trébucq A, Zamora V, Zishiri C, Hinderaker SG, Aït-Khaled N, Roggi A, Caminero Luna J, Graham SM, Dlodlo RA, Fujiwara PI. Challenges and opportunities to prevent tuberculosis in people living with HIV in low-income countries. Int J Tuberc Lung Dis 2020; 23:241-251. [PMID: 30808459 DOI: 10.5588/ijtld.18.0207] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
People living with the human immunodeficiency virus (HIV) (PLHIV) are at high risk for tuberculosis (TB), and TB is a major cause of death in PLHIV. Preventing TB in PLHIV is therefore a key priority. Early initiation of antiretroviral therapy (ART) in asymptomatic PLHIV has a potent TB preventive effect, with even more benefits in those with advanced immunodeficiency. Applying the most recent World Health Organization recommendations that all PLHIV initiate ART regardless of clinical stage or CD4 cell count could provide a considerable TB preventive benefit at the population level in high HIV prevalence settings. Preventive therapy can treat tuberculous infection and prevent new infections during the course of treatment. It is now established that isoniazid preventive therapy (IPT) combined with ART among PLHIV significantly reduces the risk of TB and mortality compared with ART alone, and therefore has huge potential benefits for millions of sufferers. However, despite the evidence, this intervention is not implemented in most low-income countries with high burdens of HIV-associated TB. HIV and TB programme commitment, integration of services, appropriate screening procedures for excluding active TB, reliable drug supplies, patient-centred support to ensure adherence and well-organised follow-up and monitoring that includes drug safety are needed for successful implementation of IPT, and these features would also be needed for future shorter preventive regimens. A holistic approach to TB prevention in PLHIV should also include other important preventive measures, such as the detection and treatment of active TB, particularly among contacts of PLHIV, and control measures for tuberculous infection in health facilities, the homes of index patients and congregate settings.
Collapse
Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, London School of Hygiene & Tropical Medicine, London, UK
| | - V Schwoebel
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - I Monedero-Recuero
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - T K Aung
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Myanmar Office, Mandalay, Myanmar
| | - S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, India
| | - C-Y Chiang
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - F Conradie
- Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa, Vital Strategies, New York, New York, USA
| | - J-P Dongo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Uganda Office, Kampala, Uganda
| | - E Heldal
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - P Jensen
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - J P K Nyengele
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, DRC Office, Kinshasa, Democratic Republic of Congo
| | - K G Koura
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Mère et enfant face aux infections tropicales Institut de recherche pour le développement, Université Paris 5, Sorbonne Paris Cité, Paris, France
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, India
| | - Y Lin
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, China Office, Beijing, China
| | - N Mlilo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Zimbabwe Office, Harare, Zimbabwe
| | - A Nakanwagi-Mukwaya
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Uganda Office, Kampala, Uganda
| | - R T Ncube
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Zimbabwe Office, Harare, Zimbabwe
| | - R Nyinoburyo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Uganda Office, Kampala, Uganda
| | - N L Oo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Myanmar Office, Mandalay, Myanmar
| | - L N Patel
- Vital Strategies, New York, New York, USA
| | - A Piubello
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Damien Foundation, Brussels, Belgium
| | - I D Rusen
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Vital Strategies, New York, New York, USA
| | - T Sanda
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, DRC Office, Kinshasa, Democratic Republic of Congo
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, India
| | - I Syed
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - A S Thu
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Myanmar Office, Mandalay, Myanmar
| | - J Tonsing
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, India
| | - A Trébucq
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - V Zamora
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Peru Office, Lima, Peru
| | - C Zishiri
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Zimbabwe Office, Harare, Zimbabwe
| | - S G Hinderaker
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, University of Bergen, Bergen, Norway
| | - N Aït-Khaled
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - A Roggi
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - J Caminero Luna
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Pneumology Department, Dr Negrin General Hospital of Gran Canaria, Las Palmas, Spain
| | - S M Graham
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - R A Dlodlo
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, Zimbabwe Office, Harare, Zimbabwe
| | - P I Fujiwara
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| |
Collapse
|
30
|
Thiyagarajan JA, Araujo de Carvalho I, Peña-Rosas JP, Chadha S, Mariotti SP, Dua T, Albanese E, Bruyère O, Cesari M, Dangour A, Dias A, Guerra M, Keeffe J, Kerse N, Khan QUA, Liu CJ, Murthy GVS, Ndegwa SN, Reginster JY, Robledo LMFG, Tremblay K, Woo J, Prince M, Beard JR. Redesigning care for older people to preserve physical and mental capacity: WHO guidelines on community-level interventions in integrated care. PLoS Med 2019; 16:e1002948. [PMID: 31626651 PMCID: PMC6799894 DOI: 10.1371/journal.pmed.1002948] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Islene Araujo de Carvalho and coauthors discuss the WHO guidelines on integrated care for older people.
Collapse
Affiliation(s)
| | | | - Juan Pablo Peña-Rosas
- Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Shelly Chadha
- Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Silvio Paolo Mariotti
- Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Emiliano Albanese
- World Health Organization Collaborating Center for Research and Training in Mental Health, University of Geneva, Geneva, Switzerland
| | - Olivier Bruyère
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy
| | - Alan Dangour
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Mariella Guerra
- Institute of Memory, Depression and Related Disorders, Lima, Peru
| | - Jill Keeffe
- World Health Organization Collaborating Centre for Prevention of Blindness, LV Prasad Eye Institute, Hyderabad, India
| | | | | | - Chiung-ju Liu
- Indiana University, Indianapolis, Indiana, United States of America
| | - Gudlavalleti V. S. Murthy
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Indian Institute of Public Health, Hyderabad, Madhapur, India
| | | | - Jean-Yves Reginster
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
| | | | - Kelly Tremblay
- University of Washington, Seattle, United States of America
| | - Jean Woo
- The Chinese University of Hong Kong, Hong Kong, China
| | - Martin Prince
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - John R. Beard
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland
- ARC Centre of Excellence on Population Ageing Research, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
31
|
Affiliation(s)
- Shelly Chadha
- Department of noncommunicable diseases, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Kaloyan Kamenov
- Department of noncommunicable diseases, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Alarcos Cieza
- Department of noncommunicable diseases, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| |
Collapse
|
32
|
Diviani N, Zanini C, Amann J, Chadha S, Cieza A, Rubinelli S. Awareness, attitudes, and beliefs about music-induced hearing loss: Towards the development of a health communication strategy to promote safe listening. Patient Educ Couns 2019; 102:1506-1512. [PMID: 30935699 DOI: 10.1016/j.pec.2019.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/26/2019] [Accepted: 03/22/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Worldwide, 1.1 billion young people are at risk of developing hearing loss due to unsafe listening. The World Health Organization plans a global health campaign to promote behavior change. In an effort to develop effective evidence-based interventions, this study identifies modifiable factors that influence listening habits. METHODS Online survey among 1019 individuals aged 18-35. The questionnaire was based on theories of behavior change. RESULTS Individuals not contemplating change showed a lack of knowledge, tended not to feel particularly at risk, and did not see the benefits of preventive measures. Conversely, those considering a change perceived more barriers (e.g., lack of information on how to act,). Self-efficacy was shown to play an ambivalent role. CONCLUSION Four factors that can be influenced by a health communication intervention were identified: risk perception, perceived safe listening level due to a lack of symptoms, knowledge, and perceived benefits and barriers, in particular perceived loss of pleasure. PRACTICE IMPLICATIONS The first aspects can be influenced through health communication interventions. Influencing the perceived loss of pleasure additionally requires an analysis of competing pressures. To support and not exceedingly burden the individual, we further suggest to address environmental aspects (e.g., policies).
Collapse
Affiliation(s)
- Nicola Diviani
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland; Health Systems, Policy and Communication Unit, Swiss Paraplegic Research, Nottwil, Switzerland.
| | - Claudia Zanini
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland; Health Systems, Policy and Communication Unit, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Julia Amann
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland; Health Systems, Policy and Communication Unit, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Shelly Chadha
- Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Alarcos Cieza
- Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Sara Rubinelli
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland; Health Systems, Policy and Communication Unit, Swiss Paraplegic Research, Nottwil, Switzerland
| |
Collapse
|
33
|
Bright T, Mújica OJ, Ramke J, Moreno CM, Der C, Melendez A, Lara Ovares E, Sandoval Domingues EI, Santana Hernandez DJ, Chadha S, Silva JC, Peñaranda A. Inequality in the distribution of ear, nose and throat specialists in 15 Latin American countries: an ecological study. BMJ Open 2019; 9:e030220. [PMID: 31326937 PMCID: PMC6661698 DOI: 10.1136/bmjopen-2019-030220] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To explore sociogeographical inequalities in the availability and distribution of ear, nose and throat specialists (ENTs) in 15 Latin American (LA) countries. DESIGN Ecological. SETTING Spanish and Portuguese-speaking countries of LA.The number of registered ENTs in 2017 was obtained from the National ENT Society in each country. OUTCOME MEASURES The ENT rate/million population was calculated at the national and subnational (eg, state) level. Three measures were calculated to assess subnational distributive inequality of ENTs: (1) absolute and (2) relative index of dissimilarity; and (3) concentration index (using the Human Development Index as the equity stratifier). Finally, the ratio of ENTs/million population in the capital area compared with the rest of the country was calculated. RESULTS There was more than a 30-fold difference in the number of ENTs/million population across the included countries-from 61.0 in Argentina (95% CI 58.7 to 63.4) to 2.8 in Guatemala (95% CI 2.1 to 3.8). In all countries, ENTs were more prevalent in advantaged areas and in capital areas. To attain distributive equality, Paraguay would need to redistribute the greatest proportion of its ENT workforce (67.3%; 95% CI 57.8% to 75.6%) and Brazil the least (18.5%; 95% CI 17.6% to 19.5%). CONCLUSIONS There is high inequality in the number and distribution of ENTs between and within the 15 studied countries in LA. This evidence can be used to inform policies that improve access to ear and hearing services in the region, such as scale-up of training of ENTs and incentives to distribute specialists equally. These actions to reduce inequities, alongside addressing the social determinants of ear and hearing health, are essential to realise Universal Health Coverage.
Collapse
Affiliation(s)
- Tess Bright
- International Centre for Evidence in Disability, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Oscar J Mújica
- Intelligence for Action in Health, Pan American Health Organization, PAHO/WHO, Washington, District of Columbia, USA
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Claudia M Moreno
- Pan American Health Organization, Washington, District of Columbia, USA
| | - Carolina Der
- Facultad de Medicina Universidad del Desarrollo, Clínica Alemana de Santiago, Santiago, Chile
| | | | - Ericka Lara Ovares
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | - Shelly Chadha
- WHO Programme for Prevention of Deafness and Hearing Loss, The World Health Organization, Geneva, Switzerland
| | - Juan Carlos Silva
- Pan American Health Organization, Washington, District of Columbia, USA
| | | |
Collapse
|
34
|
Neumann K, Chadha S, Tavartkiladze G, Bu X, White KR. Newborn and Infant Hearing Screening Facing Globally Growing Numbers of People Suffering from Disabling Hearing Loss. Int J Neonatal Screen 2019; 5:7. [PMID: 33072967 PMCID: PMC7510251 DOI: 10.3390/ijns5010007] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 01/09/2019] [Indexed: 12/24/2022]
Abstract
Recent prevalence estimates indicate that in 2015 almost half a billion people-about 6.8% of the world's population-had disabling hearing loss and that prevalence numbers will further increase. The World Health Organization (WHO) currently estimates that at least 34 million children under the age of 15 have disabling hearing loss. Based on a 2012 WHO report, approximately 7.5 million of these children were under the age of 5 years. This review article focuses on the importance of high-quality newborn and infant hearing screening (NIHS) programs as one strategy to ameliorate disabling hearing loss as a global health problem. Two WHO resolutions regarding the prevention of deafness and hearing loss have been adopted urging member states to implement screening programs for early identification of ear diseases and hearing loss in babies and young children. The effectiveness of these programs depends on factors such as governmental mandates and guidance; presence of a national committee with involvement of professionals, industries, and stakeholders; central oversight of hearing screening; clear definition of target parameters; presence of tracking systems with bi-directional data transfer from screening devices to screening centers; accessibility of pediatric audiological services and rehabilitation programs; using telemedicine where connectivity is available; and the opportunity for case discussions in professional excellence circles with boards of experts. There is a lack of such programs in middle- and low-income countries, but even in high-income countries there is potential for improvement. Facing the still growing burden of disabling hearing loss around the world, there is a need to invest in national, high-quality NIHS programs.
Collapse
Affiliation(s)
- Katrin Neumann
- Department of Phoniatrics and Pediatric Audiology, Clinic of Otorhinolaryngology, Head and Neck Surgery, Ruhr-University of Bochum, St. Elisabeth-Hospital, Bleichstr. 16, 44787 Bochum, Germany
- Correspondence: ; Tel.: +49-234-5098471; Fax: +49-234-5098393
| | - Shelly Chadha
- Blindness, Deafness Prevention, Disability and Rehabilitation Unit, Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland
| | - George Tavartkiladze
- Department of Physiology and Pathology of Hearing, National Research Centre for Audiology and Hearing Rehabilitation, 123 Leninsky ave, Moscow 117513, Russia
| | - Xingkuan Bu
- WHO Collaborating Center for the Prevention of Deafness and Hearing Impairment, Nanjing Medical University, Nanjing 210029, China
| | - Karl R. White
- National Center for Hearing Assessment and Management, Utah State University, 2615 Old Main Hill, Logan, UT 84322, USA
| |
Collapse
|
35
|
O'Donovan J, Verkerk M, Winters N, Chadha S, Bhutta MF. The role of community health workers in addressing the global burden of ear disease and hearing loss: a systematic scoping review of the literature. BMJ Glob Health 2019; 4:e001141. [PMID: 30899572 PMCID: PMC6407559 DOI: 10.1136/bmjgh-2018-001141] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 01/18/2019] [Accepted: 01/25/2019] [Indexed: 12/21/2022]
Abstract
Introduction Community health workers (CHWs) have the potential to improve access to ear and hearing services for people across low-income or middle-income countries, remote, underserved, or resource-poor areas of the world. We performed a systematic scoping review to identify evidence on how CHWs are currently deployed in the prevention, screening, diagnosis, treatment and management of ear disease and hearing loss; methods to train and support CHWs in this context; and cost-effectiveness of CHWs. Methods We performed a systematic search of the literature from September 1978 to 18 March 2018 from 11 major databases and the grey literature. Results We identified 38 original studies that met the inclusion criteria, taking place across South Asia (n=13), Oceania (n=7), North America (n=7), South America (n=6) and Africa (n=5). 23 studies showed CHWs can increase community participation in screening. They can conduct screening using whispered voice tests, noisemakers for neonatal screening, automated audiological tests and otoscopy. Eight studies focused specifically on the evaluation of programmes to train CHWs, and three provided a general programme description. Three studies documented a role of CHWs in the treatment of ear disease or hearing loss, such as performing ear washouts, instillation of topical antibiotics or fitting of hearing aids. Only one study provided an indepth cost-utility analysis regarding the use of CHWs to conduct hearing screening, and no studies commented on the role of CHWs in the prevention of hearing loss. Conclusion CHWs have been employed in diverse ways to address the global burden of ear disease and hearing loss. Future research needs to explore the role of CHWs in preventative strategies, identify optimum methods to train and support CHWs, and explore their cost-effectiveness.
Collapse
Affiliation(s)
- James O'Donovan
- Department of Education, University of Oxford, Oxford, UK.,Division of Research and Health Equity, Omni Med, Mukono, Uganda
| | - Misha Verkerk
- Department of Otolaryngology, King's College Hospital NHS Foundation Trust, London, UK
| | - Niall Winters
- Department of Education, University of Oxford, Oxford, UK
| | - Shelly Chadha
- WHO Programme for Prevention of Deafness and Hearing Loss, World Health Organization, Geneva, Switzerland
| | - Mahmood F Bhutta
- Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| |
Collapse
|
36
|
Affiliation(s)
- Shelly Chadha
- Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Alarcos Cieza
- Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Karen Reyes
- Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| |
Collapse
|
37
|
Affiliation(s)
- Shelly Chadha
- Blindness Deafness Prevention, Disability and Rehabilitation Unit, Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland
| | - Alarcos Cieza
- Blindness Deafness Prevention, Disability and Rehabilitation Unit, Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland
| | - Etienne Krug
- Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| |
Collapse
|
38
|
Singhi L, Sagili KD, Sharath BN, Bhandari K, Dadul PK, Gautam M, Ravichandra C, Chadha S, Satyanarayana S. Non-response to first-line anti-tuberculosis treatment in Sikkim, India: a risk-factor analysis study. Public Health Action 2018; 8:162-168. [PMID: 30775275 DOI: 10.5588/pha.18.0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/06/2018] [Indexed: 02/06/2023]
Abstract
Setting: Sikkim, India, has the highest proportion of tuberculosis (TB) patients on first-line anti-tuberculosis regimens with the outcome 'failure' or 'shifted to regimen for multidrug-resistant TB (MDR-TB)'. Objective: To assess the factors associated with non-response to treatment, i.e., 'failure' or 'shifted to MDR-TB regimen'. Methods: We conducted a retrospective cohort study using Revised National Tuberculosis Control Programme data of all TB patients registered in 2015 for first-line TB treatment. In addition, we interviewed 42 patients who had not responded to treatment to ascertain their current status. Results: Of 1508 patients enrolled for treatment, about 9% were classified as non-response to treatment. Patient factors associated with non-response were urban setting (adjusted odds ratio [aOR] 2.39, 95%CI 1.22-4.67), ethnicity (being an Indian tribal, aOR 1.73, 95%CI 1.17-2.57, Indian [other] aOR 1.83, 95%CI 1.29-2.60 compared to patients of Nepali origin) and those on retreatment (aOR 2.40, 95%CI 1.99-2.91). Of the patients interviewed, 28 (67%) had received treatment for drug-resistant TB. Conclusion: In Sikkim, one in 11 patients had not responded to first-line anti-tuberculosis treatment. Host-pathogen genetics and socio-behavioural studies may be required to understand the reasons for the differences in non-response, particularly among ethnic groups.
Collapse
Affiliation(s)
| | - K D Sagili
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - B N Sharath
- ESIC (Employees' State Insurance Act) Medical College and Post Graduate Institute of Medical Science and Research, Bangalore, India
| | | | | | | | | | - S Chadha
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| |
Collapse
|
39
|
Garg S, Kohli C, Mangla V, Chadha S, Singh MM, Dahiya N. An Epidemiological Study on Burden of Hearing Loss and Its Associated Factors in Delhi, India. Ann Otol Rhinol Laryngol 2018; 127:614-619. [PMID: 29938517 DOI: 10.1177/0003489418781968] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Hearing loss is the second most common cause of years lived with disability (YLD). The present study was conducted with an objective to determine the prevalence, severity, and sociodemographic correlates of hearing loss among people aged 3 months and above in selected areas of Delhi, India. MATERIAL AND METHODS A community-based cross-sectional study was conducted in selected rural and urban areas of Delhi among population aged 3 months and above. Of the total sample size of 664, 85 study subjects (17 households) were taken from the rural area, and 579 (116 households) were taken from urban areas. The hearing test and ear examination was carried out using handheld oto-acoustic emission (OAE) in children <5 years of age and pure tone audiometry in individuals above 5 years of age. SPSS software was used for data analysis. Chi-square test was used to analyze difference between proportions. RESULTS Overall prevalence of hearing loss was 25.1%. Conductive hearing loss was present among 61 (10.3%) subjects, mixed hearing loss was found among 5 (0.8%) subjects, and sensorineural hearing loss among 94 (15.8%) subjects. On OAE, 62 (89.9%) children passed the test, and 7 (10.1%) were referred. Increasing age, female gender, and low education were significantly associated with hearing loss. CONCLUSION There was high prevalence of hearing loss in the study sample. Urgent interventions are required to identify individuals with hearing loss so that its serious complications can be reduced.
Collapse
Affiliation(s)
- Suneela Garg
- 1 Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Charu Kohli
- 2 Community Medicine, North DMC Medical College & Hindu Rao Hospital, New Delhi, India
| | - Vipra Mangla
- 1 Community Medicine, Maulana Azad Medical College, New Delhi, India
| | | | | | - Neha Dahiya
- 1 Community Medicine, Maulana Azad Medical College, New Delhi, India
| |
Collapse
|
40
|
Chadha S, Trivedi A, Nagaraja SB, Sagili K. mHealth to enhance TB referrals: challenge in scaling up. In reply. Public Health Action 2018; 8:30. [PMID: 29581943 DOI: 10.5588/pha.17.0108-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S Chadha
- International Union Against Tuberculosis and Lung Disease South East Asia Office, New Delhi, India
| | - A Trivedi
- International Union Against Tuberculosis and Lung Disease South East Asia Office, New Delhi, India
| | - S B Nagaraja
- The Department of Community Medicine, Employees State Insurance Corporation (ESIC), Medical College and Post Graduate Institute of Medical Sciences and Research (PGIMSR) Hospital Bangalore, India
| | - K Sagili
- International Union Against Tuberculosis and Lung Disease South East Asia Office, New Delhi, India
| |
Collapse
|
41
|
Abstract
Globally, one in three adults has some level of measurable hearing loss, and 1.1 billion young persons are at risk for hearing loss attributable to noise exposure. Although noisy occupations such as construction, mining, and manufacturing are primary causes of hearing loss in adults, nonoccupational noise also can damage hearing. Loud noises can cause permanent hearing loss through metabolic exhaustion or mechanical destruction of the sensory cells within the cochlea. Some of the sounds of daily life, including those made by lawn mowers, recreational vehicles, power tools, and music, might play a role in the decline in hearing health. Hearing loss as a disability largely depends on a person's communication needs and how hearing loss affects the ability to function in a job. The loss of critical middle and high frequencies can significantly impair communication in hearing-critical jobs (e.g., law enforcement and air traffic control).
Collapse
|
42
|
Abstract
The World Health Organization (WHO) addresses ear diseases and hearing loss through its program on prevention of deafness and hearing loss. Recently, the World Health Assembly called for action at global and national levels to tackle the rising prevalence and adverse impact of unaddressed hearing loss. Following a public health approach toward this issue, WHO is focusing on i) raising awareness among policymakers and civil society; and ii) providing technical support to countries for promoting hearing care. Meeting this challenge requires a coordinated global effort with all stakeholders working together to make ear and hearing care accessible to all.
Collapse
Affiliation(s)
- Shelly Chadha
- WHO Department for Management of NCDs, Disability, Violence and Injury Prevention, World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland.
| | - Alarcos Cieza
- WHO Department for Management of NCDs, Disability, Violence and Injury Prevention, World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland
| |
Collapse
|
43
|
Mangla V, Garg S, Kohli C, Singh MM, Chadha S, Dahiya N. A cross-sectional study on hearing loss using world health organization protocol in Delhi. Indian J Otol 2018. [DOI: 10.4103/indianjotol.indianjotol_57_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
44
|
Waikar S, Pathak A, Ghule V, Kapoor A, Sagili K, Babu ER, Chadha S. Should sputum-negative presumptive TB patients be actively followed to identify missing cases in India? Public Health Action 2017; 7:289-293. [PMID: 29584796 DOI: 10.5588/pha.17.0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 10/07/2017] [Indexed: 11/10/2022]
Abstract
Setting: Sputum smear microscopy, the primary diagnostic tool used for diagnosis of tuberculosis (TB) in India's Revised National TB Control Programme (RNTCP), has low sensitivity, resulting in a significant number of TB cases reported as sputum-negative. As the revised guidelines pose challenges in implementation, sputum-negative presumptive TB (SNPT) patients are subjected to 2 weeks of antibiotics, followed by chest X-ray (CXR), resulting in significant loss to care among these cases. Objective: To determine whether reducing delays in CXR would yield additional TB cases and reduce initial loss to follow-up for diagnosis among SNPT cases. Methods: In an ongoing intervention in five districts of Maharashtra, SNPT patients were offered upfront CXR. Results: Of 119 male and 116 female SNPT patients with a mean age of 45 years who were tested by CXR, 32 (14%) were reported with CXR suggestive of TB. Administering upfront CXR in SNPT patients yielded twice as many additional cases, doubling the proportion of cases detected among all those tested as against administering CXR 2 weeks after smear examination. Conclusion: Our interventional study showed that the yield of TB cases was significantly greater when upfront CXR examination was undertaken without waiting for a 2-week antibiotic trial.
Collapse
Affiliation(s)
- S Waikar
- Population Services International, New Delhi, India
| | - A Pathak
- Population Services International, New Delhi, India
| | - V Ghule
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India
| | - A Kapoor
- Population Services International, New Delhi, India
| | - K Sagili
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India
| | - E R Babu
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India
| | - S Chadha
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India
| |
Collapse
|
45
|
Chadha S, Trivedi A, Nagaraja SB, Sagili K. Using mHealth to enhance TB referrals in a tribal district of India. Public Health Action 2017; 7:123-126. [PMID: 28695085 DOI: 10.5588/pha.16.0080] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 03/19/2017] [Indexed: 11/10/2022]
Abstract
Background: A mobile health (mHealth) technology based application was developed to help rural health care providers (RHCPs) identify and refer presumptive tuberculosis (TB) patients to the nearest microscopy centre for sputum examination using mobile applications on their smart phones. Objective: To determine the feasibility and yield of presumptive TB case referrals by RHCPs using mHealth technology. Methods: The project was implemented in the tribal population of Khunti District, Jharkhand State, India, from April 2012 to February 2015. 'ComCare', a mobile application designed as an aid for health care providers, was introduced and RHCPs were trained in its use. Results: Of 171 RHCPs who were formally trained to identify and refer presumptive TB patients, 30 were trained in the use of the mobile application. There were 35 referrals of presumptive TB patients per RHCP using the mobile application, and four each by RHCPs who were not using the application. Of the 194 TB cases diagnosed, RHCPs using the application contributed 127 (i.e., 4 TB cases per RHCP), while other RHCPs contributed 67 (0.5 TB case per RHCP). Conclusion: mHealth technology was highly effective, and increased both public and private health care provider accountability to patients.
Collapse
Affiliation(s)
- S Chadha
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - A Trivedi
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - S B Nagaraja
- The Department of Community Medicine, Employees State Insurance Corporation (ESIC), Medical College and Post Graduate Institute of Medical Sciences and Research (PGIMSR), Bangalore, India
| | - K Sagili
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| |
Collapse
|
46
|
Affiliation(s)
- Shelly Chadha
- WHO Department for Management of NCDs, Disability, Violence and Injury Prevention World Health Organization Geneva, Geneva, Switzerland,
| | - Alarcos Cieza
- WHO Department for Management of NCDs, Disability, Violence and Injury Prevention World Health Organization Geneva, Geneva, Switzerland,
| |
Collapse
|
47
|
Davis A, McMahon CM, Pichora-Fuller KM, Russ S, Lin F, Olusanya BO, Chadha S, Tremblay KL. Aging and Hearing Health: The Life-course Approach. Gerontologist 2017; 56 Suppl 2:S256-67. [PMID: 26994265 DOI: 10.1093/geront/gnw033] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Sensory abilities decline with age. More than 5% of the world's population, approximately 360 million people, have disabling hearing loss. In adults, disabling hearing loss is defined by thresholds greater than 40 dBHL in the better hearing ear.Hearing disability is an important issue in geriatric medicine because it is associated with numerous health issues, including accelerated cognitive decline, depression, increased risk of dementia, poorer balance, falls, hospitalizations, and early mortality. There are also social implications, such as reduced communication function, social isolation, loss of autonomy, impaired driving ability, and financial decline. Furthermore, the onset of hearing loss is gradual and subtle, first affecting the detection of high-pitched sounds and with difficulty understanding speech in noisy but not in quiet environments. Consequently, delays in recognizing and seeking help for hearing difficulties are common. Age-related hearing loss has no known cure, and technologies (hearing aids, cochlear implants, and assistive devices) improve thresholds but do not restore hearing to normal. Therefore, health care for persons with hearing loss and people within their communication circles requires education and counseling (e.g., increasing knowledge, changing attitudes, and reducing stigma), behavior change (e.g., adapting communication strategies), and environmental modifications (e.g., reducing noise). In this article, we consider the causes, consequences, and magnitude of hearing loss from a life-course perspective. We examine the concept of "hearing health," how to achieve it, and implications for policy and practice.
Collapse
Affiliation(s)
| | - Catherine M McMahon
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
| | | | - Shirley Russ
- UCLA Center for Healthier Children, Families and Communities, Los Angeles, California
| | - Frank Lin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | | | | | - Kelly L Tremblay
- Department of Speech and Hearing Sciences, University of Washington, Seattle.
| |
Collapse
|
48
|
Tripathy JP, Prasad BM, Shewade HD, Kumar AMV, Zachariah R, Chadha S, Tonsing J, Harries AD. Cost of hospitalisation for non-communicable diseases in India: are we pro-poor? Trop Med Int Health 2016; 21:1019-1028. [PMID: 27253634 DOI: 10.1111/tmi.12732] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To estimate out-of-pocket (OOP) expenditure due to hospitalisation from NCDs and its impact on households in India. METHODS The study analysed nationwide representative data collected by the National Sample Survey Organisation in 2014 that reported health service utilisation and healthcare-related OOP expenditure by income quintiles and by type of health facility (public or private). The recall period for inpatient hospitalisation expenditure was 365 days. Consumption expenditure was collected for a recall period of 1 month. OOP expenditure amounting to >10% of annual consumption expenditure was termed as catastrophic. Weighted analysis was performed. RESULTS The median expenditure per episode of hospitalisation due to NCDs was USD 149 - this was ~3 times higher among the richest quintile compared to poorest quintile. There was a significantly higher prevalence of catastrophic expenditure among the poorest quintile, more so for cancers (85%), psychiatric and neurological disorders (63%) and injuries (63%). Mean private-sector OOP hospitalisation expenditure was nearly five times higher than that in the public sector. Medicines accounted for 40% and 27% of public- and private-sector OOP hospitalisation expenditure, respectively. CONCLUSION Strengthening of public health facilities is required at community level for the prevention, control and management of NCDs. Promotion of generic medicines, better availability of essential drugs and possible subsidisation for the poorest quintile will be measures to consider to reduce OOP expenditure in public-sector facilities.
Collapse
Affiliation(s)
- J P Tripathy
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - B M Prasad
- Project Axshya, International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - H D Shewade
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - R Zachariah
- Brussels Operational Centre, Médecins Sans Frontieres, Luxembourg City, Luxembourg
| | - S Chadha
- Project Axshya, International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - J Tonsing
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France.,London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
49
|
Chadha S, Kale S. Simple fluorescence-based high throughput cell viability assay for filamentous fungi. Lett Appl Microbiol 2015; 61:238-44. [DOI: 10.1111/lam.12460] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 06/09/2015] [Accepted: 06/18/2015] [Indexed: 01/28/2023]
Affiliation(s)
- S. Chadha
- Nuclear Agriculture and Biotechnology Division; Bhabha Atomic Research Centre; Mumbai India
| | - S.P. Kale
- Nuclear Agriculture and Biotechnology Division; Bhabha Atomic Research Centre; Mumbai India
| |
Collapse
|
50
|
Chadha S. International perspective: reducing hearing loss. J Prim Health Care 2015; 7:4. [PMID: 25770710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Shelly Chadha
- Prevention of Deafness and Hearing Loss, World Health Organization, Geneva, Switzerland.
| |
Collapse
|